Abstract:

The overall purpose of the study was to implement a family intervention program for use with families of children with autism spectrum disorder (ASD) and to test its effectiveness with these families. The intervention is innovative because it introduced the use of the community health worker or “promotora de salud” model to the field of ASD interventions. A promotora is a community health worker who is indigenous to the community and receives training to provide education and to encourage behavioral changes. Promotoras are usually natural helpers, are frequently women who are insiders in their communities, and can often motivate other community members through modeling and social persuasion (Reinschmidt et al., 2006). This model has been used successfully with Latino populations in the United States to provide education and encourage positive health behaviors related to chronic diseases (Balcázar et al., 2005). Promotoras are also used in South America for general health education and advocacy and have become institutionalized in health and mental health care in some countries (Stacciarini et al. 2015). However, they have not been used for parent education on ASD in Colombia where this study took place.

Due to the scarcity of resources for families of children with ASD in Colombia, it was critical to develop ways that families can be served on limited resources. Therefore, finding ways to provide services in a cost-effective way is essential to ensuring more children with ASD receive support. An additional component of the project is that the promotoras are not just members of the community they serve; they are also parents of children with ASD. From previous work, we know that having parents carry out the role of promotora is very powerful because of their use of social support and social persuasion. However, what has not been investigated is whether therapists in training (university students) who are trained in the intervention can be equally effective and if participating in this intervention can enhance their own preparation and knowledge of working with families. If so, using therapists in training who must fulfill field training hours could also be a cost- effective way to provide this education to families.

As such, this study trained promotoras (parents, university students) to deliver a 14-week intervention (weekly 2-hour home visits) to families of children with ASD. In total, 20 families participated in the program. Interviews were conducted with families and promotoras, and parent measures including the Family Outcome Scale, the Center for Epidemiological Studies Depression Scale and a scale developed to measure use of evidence- based strategies were administered. Interviews with promotoras resulted in a number of themes emerging including family gains, personal benefits, shared experiences with families, circumstantial situations impacting implementation, overcoming difficulties, and suggestions for program enhancements. Families were particularly positive about the experience and discussed the strengths of the program, their application of knowledge learned, program improvements, and personal reflections. Also, parents improved in their use of evidenced-based strategies and reported fewer depressive symptoms. The findings of the study showed that this type of parent program is promising to assist families that have limited resources.

Keywords:

Special Education, Autism, Families.